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Radiographic evaluation of cementation technique using polished, conical, triple-tapered femoral stem in hip arthroplasty()

OBJECTIVE: To radiographically evaluate the quality of cementation and implantation technique using a polished, triple-tapered femoral stem in total hip arthroplasty (THA). METHOD: Retrospective study with radiographic evaluation of 86 hips in 83 patients who underwent to primary THA with the triple...

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Detalles Bibliográficos
Autores principales: Schuroff, Ademir Antônio, Deeke, Mark, Pedroni, Marco Antônio, Lupselo, Fernando Silva, Kunz, Rodrigo Ernesto, Lima, Alexandre Matos
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5620013/
https://www.ncbi.nlm.nih.gov/pubmed/28971085
http://dx.doi.org/10.1016/j.rboe.2017.08.019
Descripción
Sumario:OBJECTIVE: To radiographically evaluate the quality of cementation and implantation technique using a polished, triple-tapered femoral stem in total hip arthroplasty (THA). METHOD: Retrospective study with radiographic evaluation of 86 hips in 83 patients who underwent to primary THA with the triple-tapered cemented femoral stem C-Stem (DePuy Orthopedics, Warsaw, Indiana). Cases with at least one-year of follow-up were included, and data related to preoperative, immediate postoperative, and late postoperative radiographic evolution were recorded. This study analyzed, among others, the proximal femoral anatomy, the quality of cementation as described by Barrack, and the implant positioning. Cementation was also evaluated and quantified in the Gruen zones with one-year of follow-up. RESULTS: The mean age was 62.85 years. Proximal femoral anatomical conformation was Dorr type A in 34 (39.53%) cases, type B in 52 (60.46%), and no type C cases were found. Five (5.81%) cases were defined as type A by Barrack's cementation classification system, 46 (56.49%) type B, 27 (31.40%) type C, and eight (9.30%) type D. The greatest cement mantle thickness was observed in zones four (15.53 mm) and 11 (15.64 mm), and the smallest in zone nine (3.51 mm). Positioning in varus was observed in eight (9.3%) cases, valgus in 25 (29%), forward deviation in two (5%), and backward deviation in 55 (63.95%). CONCLUSIONS: The C-Stem femoral system presented satisfactory results related to cementation pattern, positioning, osteolysis, and stress shielding with regard to literature referring to double-tapered or triple-tapered models, demonstrating to be a safe method, with a predictable and reliable cementing pattern.